更新于：2024-11-01
Aspirin/Dipyridamole
阿司匹林/双嘧达莫
更新于：2024-11-01
概要
基本信息
最高研发阶段批准上市 |
首次获批日期 中国 (1994-01-01), |
最高研发阶段(中国)批准上市 |
特殊审评- |
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结构
分子式C33H48N8O8 |
InChIKeyNOHUXXDTQJPXSB-UHFFFAOYSA-N |
CAS号87653-67-6 |
关联
28
项与 阿司匹林/双嘧达莫 相关的临床试验A Randomized Controlled Trial to Evaluate the Outcomes With Aggrenox in Patients With SARS-CoV-2 Infection
PercutaNEOus Coronary Intervention Followed by Monotherapy INstead of Dual Antiplatelet Therapy in the SETting of Acute Coronary Syndromes: The NEO-MINDSET Trial A Drug Reduction Study for Patients With Acute Coronary Syndrome in the Unified Health System in Brazil
Dipyridamole Assessment for Flare Reduction in SLE
100 项与 阿司匹林/双嘧达莫 相关的临床结果
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100 项与 阿司匹林/双嘧达莫 相关的转化医学
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100 项与 阿司匹林/双嘧达莫 相关的专利（医药）
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58
项与 阿司匹林/双嘧达莫 相关的文献（医药）2024-08-01Pain Physician
Updated Assessment of Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant Therapy in Interventional Pain Management.
Article
作者: Manchikanti, Laxmaiah ; Hirsch, Joshua A ; Soin, Amol ; Pampati, Vidyasagar ; Sanapati, Mahendra R
BACKGROUND:
The role of antiplatelet/anticoagulant therapy is well known for its primary and secondary prevention of sequela from cardiovascular disease by decreasing the incidence of acute cerebral, cardiovascular, peripheral vascular, and other thrombo-embolicevents. The overwhelming data show that the risk of thrombotic events is significantly higher than that of bleeding during surgery after antiplatelet drug discontinuation. It has been assumed that discontinuing antiplatelet therapy prior to performing interventional pain management techniques is a common practice, even though doing so may potentially increase the risk of acute cerebral and cardiovascular events. A survey of practice patterns was conducted in 2012, since then the risks associated with thromboembolic events and bleeding, has not been systematically evaluated.
OBJECTIVE:
To conduct an updated assessment of the perioperative antiplatelet and anticoagulant practice patterns of U.S. interventional pain management physicians and compare this with data collected in 2012 with 2021 data regarding practice patterns of continuing or discontinuing anticoagulant therapy. STUDY DESIGNn: Postal survey of interventional pain management physicians.
STUDY SETTING:
Interventional pain management practices in the United States.
METHODS:
The survey was conducted based on online responses of the members of the American Society of Interventional Pain Physicians (ASIPP) in 2021. The survey was designed similar to the 2012 survey to assess updated practice patterns.
RESULTS:
The questionnaire was sent out to 1,700 members in October 2021. Out of these, 185 members completed the survey, while 105 were returned due to invalid addresses. The results showed that 23% changed their practice patterns during the previous year. The results also showed that all physicians discontinued warfarin therapy with the majority of physicians accepting an INR of 1.5 as a safe level. Low dose aspirin (81 mg) was discontinued for 3 to 7 days for low-risk procedures by 8% of the physicians, 34% of the physicians for moderate or intermediate risk procedures, whereas they were discontinued by 76% of the physicians for high-risk procedures. High dose aspirin (325 mg) was discontinued at a higher rate. Antiplatelet agents, including dipyridamole, cilostazol, and Aggrenox (aspirin, extended-release dipyridamole) were discontinued from 3 to 5 days by 18%-23% of the physicians for low-risk procedures, approximately 60% of the physicians for moderate or intermediate-risk procedures, and over 90% of the physicians for high-risk procedures. Platelet aggregation inhibitors clopidogrel, prasugrel, ticlopidine, and ticagrelor were discontinued for 3 to 5 days by approximately 26% to 41% for low-risk procedures, almost 90% for moderate or intermediate-risk procedures, and over 97% for high-risk procedures. Thrombin inhibitor dabigatran was discontinued by 33% of the physicians for low-risk procedures, 92% for moderate or intermediate-risk procedures, and 99% for high-risk procedures. Anti-Xa agents, apixaban, rivaroxaban, and Edoxaban were discontinued in over 25% of the physicians for low-risk procedures, approximately 90% for moderate or intermediate-risk procedures, and 99% for high-risk procedures.
LIMITATIONS:
This study was limited by its being an online survey of the membership of one organization in one country, that there was only a 11.6% response rate, and the sample size is relatively small. Underreporting in surveys is common. Further, the incidence of thromboembolic events or epidural hematomas was not assessed.
CONCLUSION:
The results in the 2021 survey illustrate a continued pattern of discontinuing antiplatelet and anticoagulant therapy in the perioperative period. The majority of discontinuation patterns appear to fall within guidelines.
2019-01-11Pain physician3区 · 医学
Responsible, Safe, and Effective Use of
Antithrombotics and Anticoagulants in
Patients Undergoing Interventional Techniques:
American Society of Interventional Pain
Physicians (ASIPP) Guidelines
3区 · 医学
Review
作者: Amol Soin ; Cyrus Bakhit ; Ramarao Pasupuleti ; Sudhir Diwan ; Jay S. Grider ; Michael E. Harned ; Muhammad Anwar ; Kenneth D. Candido ; Ramsin M. Benyamin ; Matthew R. Eng ; Elyse M. Cornett ; Mahendra Sanapati ; Matthew B. Novitch ; Hari Prabhakar ; Nebojsa Nick Knezevic ; Mark R. Jones ; Imran N. Mungrue ; Erik M. Helander ; Richard E. Latchaw ; Joshua A. Hirsch ; Timothy R. Deer ; Alan D. Kaye ; Sheri L. Albers ; John R. Swicegood ; Ricardo Vallejo ; Douglas Beall ; Thomas T. Simopoulos ; Salahadin Abdi ; Laxmaiah Manchikanti ; Richard D. Urman ; Sairam Atluri
Background: Interventional pain management involves diagnosis and treatment of chronic
pain. This specialty utilizes minimally invasive procedures to target therapeutics to the central
nervous system and the spinal column. A subset of patients encountered in interventional pain are
medicated using anticoagulant or antithrombotic drugs to mitigate thrombosis risk. Since these
drugs target the clotting system, bleeding risk is a consideration accompanying interventional
procedures. Importantly, discontinuation of anticoagulant or antithrombotic drugs exposes
underlying thrombosis risk, which can lead to significant morbidity and mortality especially in those
with coronary artery or cerebrovascular disease. This review summarizes the literature and provides
guidelines based on best evidence for patients receiving anti-clotting therapy during interventional
pain procedures.
Study Design: Best evidence synthesis.
Objective: To provide a current and concise appraisal of the literature regarding an assessment
of the bleeding risk during interventional techniques for patients taking anticoagulant and/or
antithrombotic medications.
Methods: A review of the available literature published on bleeding risk during interventional pain
procedures, practice patterns and perioperative management of anticoagulant and antithrombotic
therapy was conducted. Data sources included relevant literature identified through searches of
EMBASE and PubMed from 1966 through August 2018 and manual searches of the bibliographies
of known primary and review articles.
Results:
1. There is good evidence for risk stratification by categorizing multiple interventional
techniques into low-risk, moderate-risk, and high-risk. Also, their risk should be upgraded based on other risk factors.
2. There is good evidence for the risk of thromboembolic events in patients who interrupt antithrombotic therapy.
3. There is good evidence supporting discontinuation of low dose aspirin for high risk
and moderate risk procedures for at least 3 days, and there is moderate evidence that
these may be continued for low risk or some intermediate risk procedures.4. There is good evidence that discontinuation of anticoagulant therapy with warfarin, heparin, dabigatran
(Pradaxa®), argatroban (Acova®), bivalirudin (Angiomax®), lepirudin (Refludan®), desirudin (Iprivask®), hirudin,
apixaban (Eliquis®), rivaroxaban (Xarelto®), edoxaban (Savaysa®, Lixiana®), Betrixaban(Bevyxxa®), fondaparinux
(Arixtra®) prior to interventional techniques with individual consideration of pharmacokinetics and pharmacodynamics of the drugs and individual risk factors increases safety.
5. There is good evidence that diagnosis of epidural hematoma is based on severe pain at the site of the injection,
rapid neurological deterioration, and MRI with surgical decompression with progressive neurological dysfunction
to avoid neurological sequelae.
6. There is good evidence that if thromboembolic risk is high, low molecular weight heparin bridge therapy can be
instituted during cessation of the anticoagulant, and the low molecular weight heparin can be discontinued 24
hours before the pain procedure.
7. There is fair evidence that the risk of thromboembolic events is higher than that of epidural hematoma formation with the interruption of antiplatelet therapy preceding interventional techniques, though both risks are
significant.
8. There is fair evidence that multiple variables including anatomic pathology with spinal stenosis and ankylosing
spondylitis; high risk procedures and moderate risk procedures combined with anatomic risk factors; bleeding
observed during the procedure, and multiple attempts during the procedures increase the risk for bleeding complications and epidural hematoma.
9. There is fair evidence that discontinuation of phosphodiesterase inhibitors is optional (dipyridamole [Persantine],
cilostazol [Pletal]. However, there is also fair evidence to discontinue Aggrenox [dipyridamole plus aspirin]) 3 days
prior to undergoing interventional techniques of moderate and high risk.
10. There is fair evidence to make shared decision making between the patient and the treating physicians with the
treating physician and to consider all the appropriate risks associated with continuation or discontinuation of
antithrombotic or anticoagulant therapy.
11. There is fair evidence that if thromboembolic risk is high antithrombotic therapy may be resumed 12 hours after
the interventional procedure is performed.
12. There is limited evidence that discontinuation of antiplatelet therapy (clopidogrel [Plavix®], ticlopidine [Ticlid®], Ticagrelor [Brilinta®] and prasugrel [Effient®]) avoids complications of significant bleeding and epidural
hematomas.
13. There is very limited evidence supporting the continuation or discontinuation of most NSAIDs, excluding aspirin,
for 1 to 2 days and some 4 to 10 days, since these are utilized for pain management without cardiac or cerebral
protective effect.
Limitations: The continued paucity of the literature with discordant recommendations.
Conclusion: Based on the survey of current literature, and published clinical guidelines, recommendations for patients presenting
with ongoing antithrombotic therapy prior to interventional techniques are variable, and are based on comprehensive analysis of
each patient and the risk-benefit analysis of intervention.
Key words: Perioperative bleeding, bleeding risk, practice patterns, anticoagulant therapy, antithrombotic therapy, interventional
techniques, safety precautions, pain
2019-01-01Journal of thrombosis and haemostasis : JTH2区 · 医学
Preventing arteriovenous shunt failure in hemodialysis patients: a population‐based cohort study
2区 · 医学
Article
作者: Wu, H H ; Yang, C W ; Chang, T-Y ; Liu, S H ; Lee, C C ; Kuo, C F ; Tian, Y C ; Weng, C H ; Hsieh, M Y ; Fan, P Y ; Tu, K H ; Li, I-J
Essentials Uncertainty remains about antiplatelets for vascular access patency in hemodialysis patients. 95 971 people under hemodialysis were followed in a claims database in Taiwan. Aspirin reduced vascular access failure rate and did not increase major bleeding rate. Clopidogrel, Aggrenox, and warfarin might increase major bleeding rate. SUMMARY: Background Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. Objectives This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Patients and methods We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from 1 January 1997 to 31 December 2012. A total of 95 971 patients were enrolled in our study. Vascular access dysfunction was defined as the need for thrombectomy or percutaneous angioplasty. Major bleeding was defined as emergency department visits or hospitalization with a primary diagnosis of gastrointestinal bleeding or intracerebral hemorrhage. The adjusted odds ratios between person-quarters with or without antiplatelet or oral anticoagulant use were calculated using a generalized estimating equation. Results The odds ratio of vascular access failure was 0.21 (0.11-0.39) for aspirin, 0.76 (0.74-0.79) for clopidogrel, 0.67 (0.59-0.77) for dipyridamole, 0.67 (0.53-0.86) for Aggrenox and 0.96 (0.90-1.03) for warfarin. The highest odds ratio for intracerebral hemorrhage was 5.33 (1.25-22.72) in younger patients using Aggrenox. The highest odds ratio for gastrointestinal bleeding was 1.34 (1.10-1.64) for clopidogrel. Conclusion Antiplatelet agents, but not warfarin, might reduce the vascular access thrombosis rate. The gastrointestinal bleeding rate was increased in the group using clopidogrel. Aggrenox should be used with caution in young individuals because it might increase the rate of intracerebral hemorrhage.
3
项与 阿司匹林/双嘧达莫 相关的新闻（医药）
2022-04-26
100 项与 阿司匹林/双嘧达莫 相关的药物交易
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研发状态
批准上市
10 条最早获批的记录, 后查看更多信息
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| 适应症 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|
| 脑卒中 | 加拿大 | 2000-04-17 | |
| 短暂性脑缺血发作 | 美国 | 1999-11-22 | |
| 缺血性卒中 | 美国 | 1999-11-22 | |
| 大脑梗塞 | 中国 | 1994-01-01 |
未上市
10 条进展最快的记录, 后查看更多信息
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| 适应症 | 最高研发状态 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|---|
| 新冠肺炎后遗症 | 临床3期 | 美国 | 2020-10-21 | |
| 脑梗塞 | 临床3期 | 日本 | 2006-04-01 | |
| 头痛 | 临床3期 | 中国台湾 | 2002-09-01 |
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临床结果
临床结果
适应症
分期
评价
查看全部结果
N/A | 18 | (Extended Release Dipyridamole/Aspirin) | 範選淵鏇遞範糧憲憲鏇(齋獵願觸齋觸網鏇積願) = 壓膚襯糧衊鏇糧構範淵 餘鏇構餘糧鏇獵襯繭餘 (壓齋簾廠繭顧鹽膚願膚, 遞膚襯蓋鬱築廠築蓋餘 ~ 簾淵糧蓋醖廠艱壓鑰壓) 更多 | - | 2020-11-25 | ||
(Aspirin) | 範選淵鏇遞範糧憲憲鏇(齋獵願觸齋觸網鏇積願) = 觸願積遞壓壓蓋淵觸糧 餘鏇構餘糧鏇獵襯繭餘 (壓齋簾廠繭顧鹽膚願膚, 構齋襯夢齋顧鏇艱淵構 ~ 選鹹憲鏇廠蓋憲製壓遞) 更多 | ||||||
N/A | - | 艱膚製襯鏇淵壓衊簾鑰(獵襯窪網網範餘製憲積) = 鏇淵製選範壓糧餘鑰糧 繭築觸繭齋範獵選窪齋 (選願餘觸襯製遞鑰壓艱, 0.10 ~ 0.28) 更多 | 积极 | 2018-10-23 | |||
艱膚製襯鏇淵壓衊簾鑰(獵襯窪網網範餘製憲積) = 鏇窪觸顧願餘膚衊構餘 繭築觸繭齋範獵選窪齋 (選願餘觸襯製遞鑰壓艱, 0.67 ~ 0.71) 更多 | |||||||
N/A | 664 | (Device Closure) | 廠獵鹹範衊築醖積遞築(夢顧糧網選顧繭壓鹹築) = 夢鬱醖憲構築窪鬱鬱艱 鑰壓艱構壓簾襯鹹鑰製 (願顧觸餘醖夢淵顧鏇衊, 繭衊網襯鬱範蓋襯窪網 ~ 鹹積構壓範蓋夢鑰夢觸) 更多 | - | 2018-08-09 | ||
(Medical Management) | 廠獵鹹範衊築醖積遞築(夢顧糧網選顧繭壓鹹築) = 衊顧艱膚壓襯廠鬱網憲 鑰壓艱構壓簾襯鹹鑰製 (願顧觸餘醖夢淵顧鏇衊, 積鏇網願淵醖積廠鏇壓 ~ 繭齋襯糧醖遞簾鬱衊窪) 更多 | ||||||
N/A | 25 | (Dipyridamole 200mg and Aspirin 25mg Bid) | 繭觸淵餘餘醖鬱窪鹹襯(觸願顧構醖繭憲製衊夢) = 餘糧範壓窪衊鑰遞艱廠 構鏇網構鹹窪齋簾製遞 (廠鑰壓獵憲淵鑰夢餘構, 顧鏇鏇膚繭獵鏇壓選顧 ~ 範艱窪襯願範襯衊製夢) 更多 | - | 2017-09-05 | ||
(Dipyridamole 200 mg Bid) | 繭觸淵餘餘醖鬱窪鹹襯(觸願顧構醖繭憲製衊夢) = 夢鏇網顧製齋製膚膚網 構鏇網構鹹窪齋簾製遞 (廠鑰壓獵憲淵鑰夢餘構, 製蓋積醖遞鹹鏇壓構鹽 ~ 淵餘壓齋蓋積繭遞醖構) 更多 | ||||||
临床3期 | 1,295 | (Aggrenox Capsule) | 積鏇築鑰糧選鏇衊醖醖(膚選齋淵鑰廠壓網廠製) = 醖壓艱餘範構獵簾艱夢 網膚淵蓋繭蓋積築獵鹹 (齋憲醖觸鑰築壓蓋襯齋, 顧鹹窪糧鏇構淵鹽積鹽 ~ 窪積築廠鏇製選獵壓衊) 更多 | - | 2010-03-11 | ||
Acetylsalicylic Acid (ASA) (Acetylsalicylic Acid (ASA) 81 mg Tablet) | 積鏇築鑰糧選鏇衊醖醖(膚選齋淵鑰廠壓網廠製) = 廠鹹壓夢淵淵繭選選壓 網膚淵蓋繭蓋積築獵鹹 (齋憲醖觸鑰築壓蓋襯齋, 網窪夢夢膚廠膚艱範願 ~ 簾遞鏇簾製製憲積衊顧) 更多 | ||||||
临床4期 | 20,332 | Dipyridamole+Aspirin (Aspirin + Extended Release Dipyridamole) | 範蓋繭獵獵遞襯簾選顧(選鏇願鬱簾憲鏇構簾醖) = 齋築衊遞襯鹽簾糧鑰範 襯選構醖醖願範齋構衊 (糧鬱醖遞鹹積築淵廠衊, 遞艱襯積鹽簾構艱糧選 ~ 膚淵簾壓鬱築憲窪選顧) 更多 | - | 2009-09-02 | ||
Clopidogrel (Clopidogrel) | 範蓋繭獵獵遞襯簾選顧(選鏇願鬱簾憲鏇構簾醖) = 築網艱鑰繭鑰夢鹹壓膚 襯選構醖醖願範齋構衊 (糧鬱醖遞鹹積築淵廠衊, 選築鹹壓範憲鑰窪壓齋 ~ 淵願範夢憲遞蓋範膚襯) 更多 |
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